Author + information
- Sami Aljohani,
- Fahad Alqahtani,
- Ahmed Almustafa,
- Khaled Boobes,
- Mohammad Akram Kawsara,
- Chalak Berzingi and
- Mohamad Alkhouli
Background: Acute kidney injury (AKI) is a common complication following aortic valve replacement (AVR). We sought to describe the temporal trends of AKI requiring dialysis (AKI-D) and its impact on in-hospital mortality in patients undergoing AVR in a nationwide representative sample.
Methods: We used the Nationwide Inpatient Sample to identify 138,092 patients who underwent AVR between 2004-2013, of whom 2498 (1.8%) developed AKI-D postoperatively. Multivariable logistic regression derived propensity scores were matched 1:1 to attain 2431 pairs of patients who experienced AKI-D versus those who did not to assess in-hospital outcomes.
Results: The incidence of AKI-D increased from 2004 to 2013 (p=0.017), with a non-significant decrease of in-hospital mortality (p=0.323). In a propensity matched comparison, AKI-D group was associated with increased mortality compared to non-AKI group (34.3% vs 9% p= <0.001). Heart failure (OR=1.9, p=<0.001), coagulopathy (OR=1.4, p=<0.001), preoperative renal dysfunction (OR=1.25, p=0.023) and concurrent coronary bypass grafting (OR=1.25, p=0.027) were independent predictors of mortality in patients with AKI-D.
Conclusions: Our study reveals worsening trends of AKI-D after AVR in the United States. The development of AKI-D confers a 4-folds increase in in-hospital mortality, and this excess mortality remained constant during the study period. These results signify the need for avenues to prevent, recognize and treat AKI in patients undergoing AVR.
Poster Hall, Hall C
Sunday, March 19, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Outcomes in Valvular Heart Disease
Abstract Category: 36. Valvular Heart Disease: Clinical
Presentation Number: 1273-028
- 2017 American College of Cardiology Foundation